Tuesday, February 21, 2012

Symptomatic Diagnosis: Metabolic Disorders

Metabolic disorders are functional and systemic health issues for which Chinese medicine has many well-developed differentiations, treatment principles, and herbal formulas.
Obesity
Emaciation
Fatigue

Obesity

  • Accumulation of phlegm and damp (excess condition)

    Clinical manifestations:
    • Obesity, XS appetite
    • Likes sweet and fatty, greasy food
    • heavy sensations in body, foggy thinking
    • Aversion to heat
    • T: Flabby; thick, greasy coat
    • P: Wiry/slippery.
    • Slippery can suggest any earth element disharmony such as abundant phlegm, heat, or food stagnation, while wiry suggests any stagnation.
    • Left untreated, the phlegm can lead to heat, leading to yin deficiency, leading to wind, leading to stroke.
    Treatment principle
    • Remove damp and phlegm
    Formula
    • Wen Dan Tang + Ping Wei San (Calm the Stomach Powder)
  • Qi deficiency (deficiency condition)

    Clinical manifestations:
    • Fatigue, weak voice, shortness of breath
    • phlegm damp accumulation
    • Aversion to cold, edema, puffy face, poor digestion, sleepy, hypofunctions.
    • Not necessarily an over eating problem, but an “under-metabolism” issue.
    • T: Pale with white coating
    • P: Thready and weak.
    Treatment principle
    • Tonify yang, raise metabolism

Emaciation

  • Spleen/Stomach deficiency (more focused on digestion)

    Clinical manifestations:
    • Anemia, malnutrition, indigestion, thin constitution with indigestion. Poor appetite, chronic loose stool, fatigue, shortness of breath, weak voice
    • Sallow or pale complexion
    • T: Pale
    • P: Weak
    Treatment principle
    • Tonify Spleen
    Formula
    • Si Jun Zi Tang (Four Gentlemen Decoction)
    • Ba Zhen Tang (Eight Treasure Decoction)
  • Qi and blood deficiency (less focused on digestion)

    Clinical manifestations:
    • Anemia, malnutrition.
    • Pale face, nails, tongue, lips
    • fatigue, dizziness, vertigo
    • yang qi and blood unable to rise to nourish head
    • T: Pale
    • P: Thready/Weak
    Formula
    • Ba Zhen Tang (Eight Treasure Decoction)
    • Stress tonic herbs such as He Shou Wu (Rx. Polygoni), E Jiao (Colla Corii Asini), Ji Xue Teng (Caulis Spatholobi)
  • Lung yin deficiency (any yin deficiency leads to a certain amount of emaciation)

    Clinical manifestations:
    • Thin, emaciated body
    • Chronic dry cough, i.e. allergies
    • Lung TB, AIDS, both lead to this sort of emaciation
    • Cough with blood streaked sputum
    • Hematemesis
    • Dry mouth, tidal fever, night sweats, five center heat
    • T: Red with scanty coat
    • P: Thready, rapid
    Treatment principle
    • Tonify yin
    Formula
    • Bai He Gu Jin Tang (Lily Combination)
    • Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) for any yin deficiency
  • Stomach Heat (genetic, or acquired, usually chronic)

    Clinical manifestations:
    • excessive appetite, hypermetabolism, bad breath, thin constitution
    • Craves cold drinks
    • Irritability
    • Scanty urine, tends to be constipated
    • T: Red with dry coat
    • P: Thready, rapid, forceful
    Formula
    • Qing Wei San (Clear the Stomach Powder)
    • Yu Nu Jian (Jade Woman Decoction) for Stomach yin deficiency due to Stomach heat
  • Liver Fire (XS heat)

    Clinical manifestations:
    • Easily angered
    • Chest and hypochondriac pain or burning
    • Bitter taste, dry mouth
    • Insomnia, restlessness
    • Dark yellow urine, constipation
    • T: Red with yellow coat
    • P: Wiry, rapid, forceful
    Formula
    • Long Dan Xie Gan Tang (Gentianna Drain the Liver Decoction)

Fatigue

  • Summerheat

    Often associated with damp, because the heat weakens the Spleen, leading to production of damp.
    Clinical manifestations:
    • Symptoms follow excessive sweating, sun stroke, and always include an exposure to heat or hot weather.
    • fatigue and weakness in extremities
    • Dehydration, shortness of breath
    • fever
    • Weak voice, thirst
    • Dusky face color if damp is involved
    • Possible loose stool
    • T: Possible greasy coat
    • P: Weak and rapid, may be soft
    Formula
    • Qing Shu Yi Qi Tang (Clear Summer-heat and Augment the Qi Decoction)
  • Accumulation of damp

    Could be associated with a Spleen deficiency if the symptoms stress it.
    Clinical manifestations:
    • Sluggish and heavy sensations.
    • Cloudy, foggy head
    • Spleen qi Def.
    • indigestion, loose stool, bloating, low appetite
    • T: Greasy coat
    • P: Soft and slippery
    Treatment principle
    • Dry damp, stimulate digestion
    Formula
    • Ping Wei San (Calm the Stomach Powder)
    • Then later, tonify spleen
  • Qi and blood deficiency

    Clinical manifestations:
    • Fatigue and Pale color
    • Pale skin, face, lips, nails… etc.
    • Dizziness, palpitations
    • T: Pale
    • P: Deep thready, weak
    Formula
    • Ba Zhen Tang (Eight Treasure Decoction)

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